Dilated cardiomyopathy can be familial genetic, and it is estimated that 2030% of children with dcm have a relative with the disease, although they may not have been diagnosed or have symptoms. The most common cause of heart failure weintraub et al, 2017, dcm is diagnosed on the basis that it cannot be explained by either abnormal loading conditions increased blood pressure or volume or coronary artery disease, where an ischaemic cardiomyopathy may occur elliott et al, 2008. Dilated cardiomyopathy symptoms and causes mayo clinic. Dilated cardiomyopathy, the most common type of the disease, is characterized by an enlarged heart with stretching of the ventricle lower chamber and atrium upper chamber. It is the most common type of cardiomyopathy and typically affects those aged 20 to 60. A rigorous workup can exclude alternative causes of left ventricular lv dilation and dysfunction, identify etiologies that may respond to specific treatments, and guide family screening. Pathophysiology of dilated cardiomyopathy full text view. As cardiomyopathy progresses, the heart becomes weaker. Ppt cardiomyopathy in neonates and children powerpoint. In idiopathic dilated cardiomyopathy, the left heart is markedly dilated and thinned, and mid wall enhancement, especially in the septum, is present in more than 50% of patients 4. Pathophysiology of dilated cardiomyopathy the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Men are more likely than women to have this type of cardiomyopathy. Primary cardiomyopathies consist of disorders namely or predominantly confined to the heart muscle, which have genetic, nongenetic, or acquired causes. Pathophysiology dilated cardiomyopathy pdf dilated cardiomyopathy is considered as the most common cause of chronic.
The diagnosis and evaluation of dilated cardiomyopathy jacc. Dilated cardiomyopathy dcm can be caused by a variety of disorders. Diagnosis and outcome of dilated cardiomyopathy in the. Dec 05, 20 pathophysiology of dilated cardiomyopathy the safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
Dilated cardiomyopathy dcm is best understood as the final common response of myocardium to diverse genetic and environmental insults. Dilated cardiomyopathy is a progressive disease of heart muscle that is characterized by ventricular chamber enlargement and contractile dysfunction. Dilated cardiomyopathy is a heritable disease in some dog breeds, including the boxer, dobermann, great dane, irish wolfhound, and st bernard. A diagnosis of dilated cardiomyopathy requires evidence of dilation and impaired contraction of the left ventricle or both ventricles eg, left ventricular ejection fraction of heart disease eg, myocarditis and. Dilated cardiomyopathy has many known and probably many unidentified causes see table causes of dilated cardiomyopathy. Authored by corinne bottsilverman of the cleveland clinic. The left ventricle, which pumps oxygenated blood to the body tissues, shows weakness in contraction systolic dysfunction and stiffness in expansion and filling. Dilated cardiomyopathy is characterized by decreased contractile function and loss of myofibril organization.
Dilated cardiomyopathy dcm is a disease of the heart muscle which causes the heart to weaken and enlarge. Dilated left ventricle with systolic dysfunction not caused by ischaemic or valvular heart disease cardiac dilatation with systolic dysfunction 3. Dilated cardiomyopathy cardiovascular disorders msd. If you break down the word cardiomyopathy you can remember that its a disease of the heart muscle because cardio stands for heart, myo muscle, and pathy disease. An echocardiogram is the most common test used to diagnose dcm, as the dilation of the ventricle and overall squeeze of the heart can be measured with this test. In many cases of cardiomyopathy, an exact cause is never known. Nonischemic dilated cardiomyopathy dcm is the most common form of cardiomyopathy.
Hypertrophic cardiomyopathy echocardiogram screening and diagnosis cardinal sign is lv hypertrophy of septum and anterolateral free wall variability in hypertrophy dilated left atrium normal to nearnormal ef septum at least 1. Clinical management of these patients is aimed at controlling congestive heart failure, treating arrhythmias, preventing pulmonary and systemic emboli, and managing chest pain. The diagnosis and evaluation of dilated cardiomyopathy alan g. The phenotype of dcm is established by means of imaging studies echocardiography being the most common 4. A diagnosis of dilated cardiomyopathy requires evidence of dilation and impaired contraction of the left ventricle or both ventricles eg, left ventricular ejection fraction pdf available in central european journal of medicine 91. Listing a study does not mean it has been evaluated by the u. Ischemic cardiomyopathy icm is the most commonly identified specific cause of dilated cardiomyopathy, accounting for more than 60% of patients with symptomatic heart failure and many more with asymptomatic left ventricular dysfunction. Dilated cardiomyopathy regardless of the cause of the disease, dilated cardiomyopathy is best described as a progressive ventricular wall thinning and dilatation accompanied with gradual functional impairment 3. However, if patients manage their symptoms properly based on the necessary precautions and regular checkups as well as recommendations from doctors, they can increase to up to 10 years period. Coronary artery disease narrowing of the hearts blood vessels.
The hallmarks of dcm are left or often biventricular enlargement with mostly global systolic hypokinesis, although some regionally more pronounced contraction abnormality may be present. Up to 25% of dilated cm is caused by genetic mutations. Signs and symptoms of dcm dilated cardiomyopathy can appear along a spectrum of no symptoms, subtle symptoms or, in the more severe cases. Prasad, md abstract dilated cardiomyopathy dcm is best understood as the. Causes and conditions associated with dilated cardiomyopathy ischemic cardiomyopathy. Previously unexplored structural and molecular events that precede and initiate dilation can now be studied in tropomodulinoverexpressing transgenic tot mice exhibiting progressive dilated cardiomyopathy. An abnormal ekg doesnt necessarily say someone has dilated cardiomyopathy. Dilated and restrictive cardiomyopathies online medical reference covers diseases of the myocardium associated with cardiac dysfunction. Dilated cardiomyopathy affects the hearts ventricles ventrihkuls and atria aytreeuh. Dilated cardiomyopathy is the third most common cause of heart failure and the most frequent reason for heart transplantation. Dilated cardiomyopathy american stroke association. Etiology and panduan ramadhan pdf pathogenesis of dilated cardiomyopathy.
Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Sarcomeric mutations of 10 genes that code for myofilaments or their supporting proteins have. Types of cardiomyopathy heart muscle diseases in children. Often, there are ventricular and supraventricular arrhythmias, conduction system abnormalities, and thromboembolism. Dilated cardiomyopathy dcm hypertrophic cardiomyopathy hcm. Types of cardiomyopathy dilated cardiomyopathy dilated cardiomyopathy is the most common type of the disease. Understanding the progression of dilated cardiomyopathy will be critical in the design of treatment modalities to intervene at the molecular level in the initial stages of pathogenesis. Feb 02, 2016 atlas of the clinical genetics of human dilated cardiomyopathy haas j et al. Dilated cardiomyopathy dcm, also known as congestive systolic cardiomyopathy, is recognized by impaired systolic function and global dilatation of either one or both ventricular chambers.
Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that. Dilated cardiomyopathy cardiovascular disorders merck. A diagram and echocardiogram comparing a normal heart and a heart with dcm are shown in figure 1a and figure 1b. The resulting damage to the heart muscle is often known as ischemic cardiomyopathy. The diagnostic work up of genetic and inflammatory dilated. Dilated cardiomyopathy may not cause any symptoms at first. Lateenhancement mr images may demonstrate areas of fibrosis within the myocardium, characteristically in the mid or subepicardial myocardium, allowing. Secondary cardiomyopathies are disorders that have myocardial damage as a result of systemic or multiorgan disease 1. Dilated cardiomyopathy is a heart muscle disorder characterized by dilation and systolic impairment of the left ventricle or both ventricles in the absence of hypertension, coronary artery disease. Dilated cardiomyopathy radiology reference article.
Typically, both the ventricles and the atria are enlarged and often the muscular walls of the heart are much thinner than normal. Over time, if your heart is not pumping as well as it should, you may feel very tired or you may find yourself short of breath after bouts of activity or after lying down. Dilated cardiomyopathy diagnosis show diagnosis of dcm is based on cardiac testing, family history, medical history, and a physical exam. In central and south america, chagas disease due to trypanosoma cruzi is the most common infectious cause. Dilated cardiomyopathy an overview sciencedirect topics. Dystrophin severe dilated cardiomyopathy elevated ck mutations in 5 end or promoter region of dystrophin gene cause cardiomyopathy muntoni, melacini 1993, milasin 1996 41. Dcm usually affects both the left and right sides of the heart.
Dilated cardiomyopathy dilated or congestive cardiomyopathy dcm is diagnosed when the heart is enlarged dilated and the pumping chambers contract poorly usually left side worse than right. Dilated cardiomyopathy is the commonest cardiomyopathy in children, accounting for up to threefifths of cases. Some causes of dcm are reversible and the condition improves once the cause is treated or eliminated or the condition subsides. It is less able to pump blood through the body and maintain a normal electrical rhythm. In the ekg of dilated cardiomyopathy its almost always abnormal but the findings are nonspecific. Compared with a normal heart, dilated cardiomyopathy causes the chambers of the heart to enlarge, which can lead to heart failure if left untreated. Dilated cardiomyopathy dcm is when the hearts ability to pump blood is lessened because its main pumping chamber, the left ventricle, is enlarged and weakened. The right ventricle may also be dilated and dysfunctional. Dilated cardiomyopathy can be genetic or acquired and typically presents with classic symptoms of heart fail ure with reduced ejection fraction. Denise antle, arnp, msn, ccrn, ccns critical care arnpcns. Feb 28, 2020 dilated cardiomyopathy can cause your heart to suddenly stop beating. Dilated and restrictive cardiomyopathies cleveland clinic. More than 20 viruses can cause dilated cardiomyopathy.
Mechanisms of damage are both acute dystrophin cleavage and delayed lymphocytic infiltrate. Inherited familial forms of dilated cardiomyopathy may occur in 2550% of patients. Dilated cardiomyopathy is a progressive, usually irreversible, disease causing global systolic contractile dysfunction with heart failure. Pdf ischemic and nonischemic dilated cardiomyopathy.
Dilated cardiomyopathy can lead to problems such as irregular heart rhythms, stroke, heart attack, and heart failure. Etiology, pathogenesis, and pathophysiology of dilated. Hypertrophic cardiomyopathy is inherited as an autosomal dominant trait. Dilated cardiomyopathy dcm, a leading cause of heart failure and heart transplantation in younger adults, is characterized by dilatation and impaired contraction of the left or both ven tricles. Engelmeier rs, oconnell jg eds drug therapy in dilated cardiomyopathy and myocarditis. Ischemic and nonischemic dilated cardiomyopathy article pdf available in central european journal of medicine 91. In more than 50 percent of cases, however, no cause can be found, and the cardiomyopathy is called idiopathic. Dilated cardiomyopathy dcm is a disease of the heart muscle which primarily affects the hearts main pumping chamber, the left ventricle. Cardiomyopathy is a disease that causes the heart muscle to become weak and ineffective, reducing the hearts ability to pump blood through the body and possibly leading to heart failure. Dilated cardiomyopathy is characterised by left ventricular dilation and dysfunction in the absence of coronary disease, valvular disease or hypertension. The left ventricle of affected individuals becomes enlarged dilated and cannot pump blood to the body with as much force as a. Abelmann wh 1988 myocarditis as a cause of dilated cardiomyopathy.
This can lead to heart failure or irregular heartbeats called arrhythmias. Jan 02, 2017 dilated cardiomyopathy dcm is a disease of the heart muscle which primarily affects the hearts main pumping chamber, the left ventricle. Common pathogenic viruses include adenovirus, enterovirus, cmv, influenza. Within the last decade, the treatment for patients with dilated cardiomyopathy has changed. Diagnosis and outcome of dilated cardiomyopathy in the fetus. Dilated cardiomyopathy is the commonest cardiomyopathy in children, and the majority present before one year of age. Cardiomyopathy information guide c a r d i o m y o p a t h y m a r d i g i a n w e l l n e s s r e s o u r c e c e n t e r page 1 other names. Restrictive cardiomyopathy is much less common and. Dcm is the most prevalent form of cardiomyopathy with an incidence of one in approximately 2500 individuals. Treatment is based on medication, including ace inhibitors, loop diuretics, and phosphodiesterase inhibitors. Proposal for a revised definition of dilated cardiomyopathy, hypokinetic nondilated cardiomyopathy, and its implications for clinical practice.
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